CEA PREP QUESTIONS AND ANSWERS SET A+
✔✔A 19-year-old patient who has used oral contraceptives for 3 years plans to
discontinue the pill at the end of her current cycle to become pregnant. Which of the
following daily supplements would receive the highest priority?
*Ferrous sulfate
*Folic acid
*Multivitamin
*Calcium carbonate - ✔✔Folic acid
Rationale: Folic acid, a B-vitamin (B9), plays a crucial role in ensuring a healthy
pregnancy and reducing the risk of birth defects. Folic acid is crucial in the early
development of the neural tube, which forms the brain and spinal cord. Adequate folic
acid intake can significantly reduce the risk of neural tube defects such as spina bifida
(incomplete closure of the spinal cord) and anencephaly (underdevelopment of the
brain). The neural tube forms very early in pregnancy, often before a woman knows she
is pregnant. Therefore, it is essential to have adequate folic acid levels before and
during early pregnancy.
✔✔A pregnant woman with known HIV infection can reduce the risk of perinatal
transmission through zidovudine (Retrovir) therapy. Based on current research, optimal
therapy is to start daily dosing:
*if maternal viral loads are greater than 10,000.
*after 14 weeks of gestation.
*if premature rupture of membranes occurs.
*post amniocentesis. - ✔✔after 14 weeks of gestation.
Rationale: Retrovir (Zidovudine) is an antiretroviral medication used to prevent mother-
to-child transmission of HIV during pregnancy, labor, and delivery. The timing of
initiating Retrovir in a pregnant woman is crucial for maximizing its effectiveness in
reducing the risk of vertical transmission of HIV. Early initiation (around 14 weeks) helps
to reduce viral load and improve maternal health, but it can be started later if needed.
✔✔A non-lactating female being treated for mastitis returns to the office after a course
of cephalexin (Keflex) with no improvement. Which diagnostic test should be considered
first?
,*Breast ultrasound
*MRI of breast
*CT scan of chest
*Mammography - ✔✔Mammography
✔✔All of the following are usually associated with an abruptio placentae EXCEPT:
*Visible or concealed hemorrhage
*A tender, hypertonic uterus
*Spotting during the first trimester
*Fetal distress - ✔✔Spotting during the first trimester
Rationale: Abruptio placentae (also known as placental abruption) is a serious
pregnancy complication where the placenta detaches partially or completely from the
inner wall of the uterus before childbirth. This condition can jeopardize both maternal
and fetal health due to the disruption of the placenta's role in providing oxygen and
nutrients to the fetus.
Symptoms include:
Vaginal Bleeding: Sudden onset of bleeding, which can range from light to heavy. Note
that the bleeding may not always be visible if it is concealed behind the placenta.
Abdominal Pain: Severe, persistent pain in the abdomen or back.
Uterine Tenderness: The uterus may feel hard or tender.
Rapid Uterine Contractions: Frequent and strong contractions.
Fetal Distress: Signs of fetal distress, such as abnormal fetal heart rate or decreased
fetal movement.
✔✔The patient recently diagnosed and treated with chemotherapy and radiation for
lymphoma develops shortness of breath and chest pain on the right side. He feels he is
unable to take a deep breath. What diagnosis based on this history is most likely?
*Hemothorax
*Pericardial tamponade
*Pleural effusion
*Left pneumothorax - ✔✔Pleural effusion
Patients undergoing treatment for lymphoma commonly develop pleural effusions in
response to the lysis of the tumor and the body's response. For this reason, many
patients with this diagnosis and treatment will have a silicone pleural catheter placed to
allow them to drain at home.
✔✔What does forced vital capacity (FVC) represent in pulmonary function testing?
*The maximum volume of air that can be inhaled after a normal exhalation.
*Maximum volume of air that can be forcefully exhaled after maximum inspiration.
*Total volume of air exhaled during the first second of forced expiration.
*Volume of air remaining in the lungs after forced exhalation - ✔✔Maximum volume of
air that can be forcefully exhaled after maximum inspiration.
Rationale: Forced Vital Capacity (FVC) is a measure of lung function that represents the
maximum volume of air that a person can forcibly exhale from their lungs after taking
the deepest breath possible. It is an important parameter in pulmonary function tests
, and is used to diagnose and monitor respiratory conditions such as asthma, chronic
obstructive pulmonary disease (COPD), and restrictive lung disease. The FVC is
typically measured using a spirometer, and it provides valuable information about the
strength and capacity of the respiratory muscles and the elasticity of the lungs and
airways.
✔✔A 57-year-old man presents with a persistent, non-productive cough and weight
loss. Chest X-ray reveals a mass in the lung apex. What is the most appropriate next
step in diagnosis?
*PET scan
*Chest CT scan
*Bronchoscopy
*Sputum culture - ✔✔Bronchoscopy
Rationale: Bronchoscopy is a diagnostic and sometimes therapeutic procedure that
allows direct visualization of the airways using a flexible or rigid bronchoscope.
✔✔The following are side effects of albuterol use except which of the following?
*Diarrhea
*Tachycardia
*Tremors after prolonged nebulized administration
*Decreased GI motility - ✔✔Diarrhea
Rationale: Beta 2 agonism can cause tachycardia, tremors, and decreased GI motility,
not diarrhea.
✔✔Which of the following assessments is most useful for evaluating respiratory function
in a patient with suspected chronic obstructive pulmonary disease (COPD)?
*Arterial blood gas (ABG) analysis
*Chest X-ray
*Spirometry
*Pulse oximetry - ✔✔Spirometry
Rationale: Spirometry is a critical diagnostic tool used for diagnosing, assessing, and
managing Chronic Obstructive Pulmonary Disease (COPD). Spirometry is essential for
diagnosing COPD by measuring how much air a person can exhale and how quickly
they can do so. The hallmark of COPD is persistent airflow obstruction.
✔✔The nurse practitioner caring for the hospitalized 14-year-old patient with multiple
days of high concentration oxygen should evaluate the patient for which of the following
exams?
*2D Echocardiography
*Facial nerve exam
*Visual acuity test
*Vagus nerve exam - ✔✔Visual acuity test
Rationale: Long duration high concentration oxygen delivery to the patient may elicit
damage to the retinal artery, especially in pediatrics and adolescents.
✔✔A 19-year-old patient who has used oral contraceptives for 3 years plans to
discontinue the pill at the end of her current cycle to become pregnant. Which of the
following daily supplements would receive the highest priority?
*Ferrous sulfate
*Folic acid
*Multivitamin
*Calcium carbonate - ✔✔Folic acid
Rationale: Folic acid, a B-vitamin (B9), plays a crucial role in ensuring a healthy
pregnancy and reducing the risk of birth defects. Folic acid is crucial in the early
development of the neural tube, which forms the brain and spinal cord. Adequate folic
acid intake can significantly reduce the risk of neural tube defects such as spina bifida
(incomplete closure of the spinal cord) and anencephaly (underdevelopment of the
brain). The neural tube forms very early in pregnancy, often before a woman knows she
is pregnant. Therefore, it is essential to have adequate folic acid levels before and
during early pregnancy.
✔✔A pregnant woman with known HIV infection can reduce the risk of perinatal
transmission through zidovudine (Retrovir) therapy. Based on current research, optimal
therapy is to start daily dosing:
*if maternal viral loads are greater than 10,000.
*after 14 weeks of gestation.
*if premature rupture of membranes occurs.
*post amniocentesis. - ✔✔after 14 weeks of gestation.
Rationale: Retrovir (Zidovudine) is an antiretroviral medication used to prevent mother-
to-child transmission of HIV during pregnancy, labor, and delivery. The timing of
initiating Retrovir in a pregnant woman is crucial for maximizing its effectiveness in
reducing the risk of vertical transmission of HIV. Early initiation (around 14 weeks) helps
to reduce viral load and improve maternal health, but it can be started later if needed.
✔✔A non-lactating female being treated for mastitis returns to the office after a course
of cephalexin (Keflex) with no improvement. Which diagnostic test should be considered
first?
,*Breast ultrasound
*MRI of breast
*CT scan of chest
*Mammography - ✔✔Mammography
✔✔All of the following are usually associated with an abruptio placentae EXCEPT:
*Visible or concealed hemorrhage
*A tender, hypertonic uterus
*Spotting during the first trimester
*Fetal distress - ✔✔Spotting during the first trimester
Rationale: Abruptio placentae (also known as placental abruption) is a serious
pregnancy complication where the placenta detaches partially or completely from the
inner wall of the uterus before childbirth. This condition can jeopardize both maternal
and fetal health due to the disruption of the placenta's role in providing oxygen and
nutrients to the fetus.
Symptoms include:
Vaginal Bleeding: Sudden onset of bleeding, which can range from light to heavy. Note
that the bleeding may not always be visible if it is concealed behind the placenta.
Abdominal Pain: Severe, persistent pain in the abdomen or back.
Uterine Tenderness: The uterus may feel hard or tender.
Rapid Uterine Contractions: Frequent and strong contractions.
Fetal Distress: Signs of fetal distress, such as abnormal fetal heart rate or decreased
fetal movement.
✔✔The patient recently diagnosed and treated with chemotherapy and radiation for
lymphoma develops shortness of breath and chest pain on the right side. He feels he is
unable to take a deep breath. What diagnosis based on this history is most likely?
*Hemothorax
*Pericardial tamponade
*Pleural effusion
*Left pneumothorax - ✔✔Pleural effusion
Patients undergoing treatment for lymphoma commonly develop pleural effusions in
response to the lysis of the tumor and the body's response. For this reason, many
patients with this diagnosis and treatment will have a silicone pleural catheter placed to
allow them to drain at home.
✔✔What does forced vital capacity (FVC) represent in pulmonary function testing?
*The maximum volume of air that can be inhaled after a normal exhalation.
*Maximum volume of air that can be forcefully exhaled after maximum inspiration.
*Total volume of air exhaled during the first second of forced expiration.
*Volume of air remaining in the lungs after forced exhalation - ✔✔Maximum volume of
air that can be forcefully exhaled after maximum inspiration.
Rationale: Forced Vital Capacity (FVC) is a measure of lung function that represents the
maximum volume of air that a person can forcibly exhale from their lungs after taking
the deepest breath possible. It is an important parameter in pulmonary function tests
, and is used to diagnose and monitor respiratory conditions such as asthma, chronic
obstructive pulmonary disease (COPD), and restrictive lung disease. The FVC is
typically measured using a spirometer, and it provides valuable information about the
strength and capacity of the respiratory muscles and the elasticity of the lungs and
airways.
✔✔A 57-year-old man presents with a persistent, non-productive cough and weight
loss. Chest X-ray reveals a mass in the lung apex. What is the most appropriate next
step in diagnosis?
*PET scan
*Chest CT scan
*Bronchoscopy
*Sputum culture - ✔✔Bronchoscopy
Rationale: Bronchoscopy is a diagnostic and sometimes therapeutic procedure that
allows direct visualization of the airways using a flexible or rigid bronchoscope.
✔✔The following are side effects of albuterol use except which of the following?
*Diarrhea
*Tachycardia
*Tremors after prolonged nebulized administration
*Decreased GI motility - ✔✔Diarrhea
Rationale: Beta 2 agonism can cause tachycardia, tremors, and decreased GI motility,
not diarrhea.
✔✔Which of the following assessments is most useful for evaluating respiratory function
in a patient with suspected chronic obstructive pulmonary disease (COPD)?
*Arterial blood gas (ABG) analysis
*Chest X-ray
*Spirometry
*Pulse oximetry - ✔✔Spirometry
Rationale: Spirometry is a critical diagnostic tool used for diagnosing, assessing, and
managing Chronic Obstructive Pulmonary Disease (COPD). Spirometry is essential for
diagnosing COPD by measuring how much air a person can exhale and how quickly
they can do so. The hallmark of COPD is persistent airflow obstruction.
✔✔The nurse practitioner caring for the hospitalized 14-year-old patient with multiple
days of high concentration oxygen should evaluate the patient for which of the following
exams?
*2D Echocardiography
*Facial nerve exam
*Visual acuity test
*Vagus nerve exam - ✔✔Visual acuity test
Rationale: Long duration high concentration oxygen delivery to the patient may elicit
damage to the retinal artery, especially in pediatrics and adolescents.
